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Right Under Your Nose: Substance Abuse in the Workplace

You might think it’s unlikely that the person giving you drugs or treating your pain during surgery may also be dolling them out to themselves.  I thought that for a long time.  All nurses have heard the story about the long lost colleague found passed out in the bathroom after diverting hospital drugs.  We tend to picture a strung out, bone thin nurse with poor hygiene just itching, both literally and metaphorically, for the next fix.  How easy would that be to spot?   Very easy, most of us think.  But what if I told you that it looks more like the dealer at a black jack table in Vegas.  That slick handed pick pocket dealing you a card while simultaneously stashing a chip or two up his sleeve.  If you’ve ever seen footage of these guys you know you’d have to squint really hard and get an instant replay complete with play-by-play commentation to see just what happened. 

Unfortunately, when you take a highly intelligent professional who becomes very motivated in only a way that drugs can manufacture and give them the combination to the safe, you have yourself a recipe for disaster.  What if you took your typical alcoholic and cleaned him up, gave him an IQ well above average, and put him behind the bar?  That is essentially what it’s like when you have an anesthesia provider addicted to the very drugs that they are administering.  That person was me not so long ago.  Although I may now be free from the clutches of active addiction and have a world of perspective, I can still conjure that moment in time.

Addicts are victims of their habit.  Whether the chicken or the egg came first is a debate that will endure for some time.  Did we become addicts because we abused drugs or did we abuse drugs because we were addicts all along?  There are a lot of opinions out there.  What I am concerned with is what this interplay looks like when the addict is the last person you’d expect.  A shape-shifting practitioner of the highest order complete with credentials and a license to throw you off the case that much more.  Spotting the addicted hospital employee can be a tall order. 

As you can imagine, drug-diverting staff go unnoticed at an alarming rate.  That person pumping on your chest during the most crucial time of your loved one’s life may be flying high on morphine.  The person putting you to sleep for your knee surgery may be giving themselves a dose of fentanyl for every dose you receive.  It happens all too often and we don’t pick up on it until that person is found mottled and dead in broom closet or a patient is injured in any number of ways. Drug diversion is a serious problem that has been poorly acknowledged for too long.  Although it may be difficult to detect, it behooves us all to be on the lookout.  As an ex-addict it would be easy for me to spot the provider who slips off to the bathroom a little too often, shows up eagerly to tally narcotics, and ever-so-slightly slurs the occasional word. 

I hope to create a dialogue for those who have suggestions or experience.  What we have done for too long is stay silent about this most taboo of topics.  Bringing awareness to this matter can only help create an appreciation for an issue that affects us all.